Physicians should explore integrating a “food as medicine” approach into practice

07 April 2022

4 minute read


Source/Disclosures


Disclosures: Platkin and Stanford report no relevant financial information.


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There is overwhelming evidence demonstrating the impact of food on health, according to a report by the Center for Food as Medicine and the Hunter College NYC Food Policy Center.

In the report, Charles Platkin, PhD, JD, MPH, the executive director of Hunter College NYC Food Policy Center and the founder and director of the Center for Food as Medicine, and his colleagues described the history of using food to treat disease, the challenges of the food as medicine movement, the current evidence and recommendations for stakeholders.





Among their findings, the researchers said that many medical schools in the United States do not require students to take basic nutrition courses.

Fatima Cody Stanford

Fatima Cody Stanford

“Several chronic diseases are linked to poor nutritional status, but there is no standard nutrition education in medical schools in the United States,” Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS, a physician specializing in obesity medicine and chief equity officer for the endocrine division of Massachusetts General Hospital, told Healio in response to the report. “It’s disconcerting because preventing and treating chronic disease often starts with healthy eating. If physicians are not sufficiently trained in how to guide patients in nutrition, we will continue to see a proliferation of diseases that could be minimized with good nutrition.

Healio spoke with Platkin to learn more about the groundbreaking report and how food as medicine is expected to change clinical practice.

Helio: What are the main lessons of the report for doctors?

Platinum: Many physicians lack the training and experience to speak confidently with patients about nutrition. Despite evidence linking food and diet to health, nutrition counseling is not often provided by clinicians, including primary care physicians, to their patients. Requiring comprehensive nutrition training as part of health care clinician training will ensure patients have equitable access to nutrition expertise, regardless of their geographic location or the type of doctor they see. . Means of ensuring the integration of nutrition into medical education curricula include legislative mandates; make public funding of schools conditional on the inclusion of nutrition courses; integration of nutrition courses into accreditation standards; and the inclusion of onboard nutrition questions and other qualifying exams.

Helio: How will inadequate nutrition training in medical school affect patient care?

Platinum: One of the reasons that PCPs may be reluctant to provide nutritional and dietary counseling to their patients could be a lack of knowledge about how to provide these nutritional interventions. Many physicians therefore have to determine the symptoms and treatments of diet-related problems without the proper training. Many physicians reported providing nutrition counseling even without any formal training in their medical curriculum on the subject.

Helio: How can food be used to treat disease?

Platinum: Various food-as-medicine programs have been shown to be effective as co-treatments for chronic diseases. Whether or not a poor diet can cause harm to the body should no longer be debated, as evidence supports potential causal relationships between dietary factors and diet-related diseases such as ischemic heart disease, diabetes and some cancers. Although food has the potential to cause disease, it is also capable of building, maintaining and restoring health. Health care systems are increasingly being encouraged to use foods as medical interventions, such as medically appropriate meals and dietary prescriptions (e.g., fruits and vegetables), as methods to achieve better health outcomes. health in patients with chronic diet-related diseases.

Despite the long history of food as medicine across history and cultures, as well as its growing popularity in our modern culture, there remain critical challenges throughout the food ecosystem that can limit the ability of diet as medicine to be actualized in practice. Some of these challenges include food insecurity, food justice and health equity; insufficient nutritional advice from clinicians; marketing of food products; and the lack of evidence-based foods as medical research to keep up with its modern popularity on the internet and social media. In addition, research funded by the food industry could contribute to biasing the results of nutritional studies, which can then skew dietary recommendations and the foods consumers choose based on their perceived health status.

Helio: Why are PCP particularly important in advancing food-as-medicine efforts?

Platinum: It has been shown that patients who receive weight loss advice from their doctor are more likely to improve their diet, increase their activity and lose weight. Therefore, advice given by a physician on diet and nutrition can be particularly effective in modifying patients’ behavior and improving their understanding of recommended dietary patterns. Dietary advice from doctors will also help patients interpret all the nutritional information they are likely to find online and on social media, thereby improving their overall nutritional knowledge.

Helio: How should supplements play a role in a doctor’s treatment plan given the lack of regulation on its ingredients?

Platinum: Individuals take dietary supplements for a variety of reasons, including to control their own treatment or to improve their overall health. However, many supplement users are unaware of the active ingredients, possible side effects, or recommended dosages of what they were taking. Patients’ lack of knowledge appears to be partly attributable to their lack of communication with healthcare professionals regarding the potential benefits and risks of supplement use. Supplement users said they avoided discussing supplement use with their doctors because they felt their doctors lacked knowledge or were biased against the practice, according to National Health and Nutrition Surveys from 2007 to 2010.

Helio: What impact does food insecurity have on health and how can physicians/practices help food insecure patients?

Platinum: Food-as-medicine programs and interventions, such as nutrition incentive programs and medically-adapted meals, can help ensure that vulnerable populations have access to fresh, nutritious food. A growing body of evidence has shown that people living in low-income and underserved communities are disproportionately affected by diet-related illnesses and chronic health conditions. Federal food assistance programs such as SNAP have been shown to significantly reduce food insecurity. However, improving access to nutritious foods alone may not be enough; programs should combine and incorporate other interventions, including nutrition and food education, transport, cooking materials and additional resources such as financial support.

Helio: do you have something anything else to add?

Platinum: Integrating food-as-medicine practices into mainstream health care is a strategy that healthcare professionals, insurance companies, policy makers, community organizations and other key stakeholders should explore to prevent and treat effectively chronic diseases, reduce health care costs and improve the quality of life of patients. The aim of our report is to bridge the gap between traditional medicine and the use of food as medicine in the prevention and treatment of disease. We hope the report will serve as a foundation for understanding the potential uses of food and diet as a therapeutic mechanism.

Reference:

Food as Medicine: Overview and Report: How Food and Diet Affect Disease Treatment and Disease Management. https://www.nycfoodpolicy.org/wp-content/uploads/2022/03/foodasmedicine.pdf. Published March 30, 2022. Accessed March 30, 2022.

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